Neuro deck Flashcards
What are the components of the scalp, and why do open wounds here tend to bleed extensively?
The scalp is composed of the skin and soft tissues covering the skull. It has a rich blood supply, causing open wounds to bleed extensively.
How should bleeding from a scalp wound be managed?
Bleeding from a scalp wound usually responds to direct pressure. If bandaging is required, ensure appropriate cervical spinal motion restriction is applied for patients with suspected cervical injuries.
What is the significance of swelling in closed scalp wounds, and how should it be treated?
Closed scalp wounds may swell rapidly due to bleeding underneath the scalp. Swelling responds best to ice packs if available.
What are the two main types of skull fractures, and how are they identified?
Skull fractures can be linear or depressed. Linear fractures appear as straight lines on X-rays, while depressed fractures are caused by localized force, resulting in a segment of the skull being buckled inward.
Why must all patients with a soft-tissue injury to the scalp be assessed for cervical spine injury?
Because of the potential for cervical spine injury associated with head trauma, spinal motion restriction should be applied accordingly.
What is the difference between open and closed skull fractures?
A closed-skull fracture occurs without a break in the skin, while an open-skull fracture is associated with a scalp laceration.
What are basilar skull fractures, and how are they detected?
Basilar skull fractures involve the bony plates at the base of the skull and cannot be detected directly. They often require CT scanning for diagnosis and are identified by specific signs such as cerebrospinal fluid leakage, Battle’s sign, and raccoon eyes.
List the signs of a basilar skull fracture.
Signs include clear fluid (cerebrospinal fluid) leaking from the nose or ear canal, bleeding from inside either ear canal, bruising and swelling behind the ear (Battle’s sign), and bruising around both eyes (raccoon eyes).
What is a cerebral contusion, and what can cause it?
A cerebral contusion is the bruising of brain tissue, often caused by a direct blow to the head. It can result from the brain shifting and impacting the opposite side of the skull (contrecoup injury).
Describe subdural and epidural hematomas and their typical causes.
Subdural hematomas are caused by venous bleeding below the dura mater, while epidural hematomas are caused by arterial bleeding above the dura mater, usually after a head injury. Both are life-threatening and often require emergency surgery.
What is a concussion, and what are its common symptoms?
A concussion is a mild form of brain injury causing a brief “short circuit” of the brain. Symptoms include headache, dizziness, nausea, confusion, and memory problems.
Why is it important to monitor the level of consciousness in patients with brain injuries?
Changes in the level of consciousness can indicate the severity and progression of brain injury. It’s important to track whether the level of consciousness is improving or deteriorating.
What must be assumed about any patient under the influence of drugs or alcohol who has sustained head or face trauma and has an altered level of consciousness?
They must be assumed to have sustained a brain injury until proven otherwise.
Why is pupil size and response to light important in assessing brain injury?
The nerve pathways controlling pupillary response travel from the eyes into the skull and down to the brain stem, and they are sensitive to changes in intracranial pressure.
What happens if intracranial pressure exceeds a critical point?
The brain stem becomes compressed, which can be fatal.
What does a dilated and sluggishly reactive or fixed pupil indicate in a patient with decreased consciousness?
It indicates severe brain injury with probable increased intracranial pressure.
How can direct trauma to the eye be differentiated from severe head injury?
Patients with direct eye trauma are usually alert and have a normal level of consciousness, unlike those with severe head injury.
What should an OFA attendant look for during the examination of the head?
Signs of a basilar skull fracture and evidence of a depressed skull fracture.
What does asymmetry of movement or sensation between the left and right sides of the body indicate?
A severe brain injury.
What are the complications of brain injury that an OFA attendant should be aware of?
Convulsions (seizures) and vomiting.
How should vomiting be managed in a patient with a brain injury?
Log-roll the patient into the lateral position while maintaining cervical spine motion restriction, clear the airway, and reposition the patient supine.
What is a stroke (CVA)?
A cerebrovascular accident causing brain damage by the sudden blockage or rupture of a cerebral artery.
What are the two main types of strokes?
Ischemic strokes and hemorrhagic strokes.
What causes ischemic strokes?
Blockage or narrowing of a cerebral artery, often due to atherosclerosis or embolism.
What causes hemorrhagic strokes?
The rupture of a cerebral artery, often at weakened regions of the vessel wall due to atherosclerosis or high blood pressure.
What are some general signs and symptoms of a stroke?
Weakness or loss of use of limbs, severe headache, nausea, confusion, visual difficulties, dizziness, unequal pupils, and changes in vital signs.
What does the mnemonic FAST stand for in stroke screening?
Face (look for droop/asymmetry), Arms (check for dropping), Speech (assess speech), Time (act quickly).
What is the first step in the management of a stroke patient?
Conduct the scene assessment and activate emergency response procedures.
What should be done if a stroke patient has a decreased level of consciousness?
Ensure an open airway, insert an oropharyngeal airway if needed, provide assisted ventilation, suction the airways, and transport the patient to a medical facility.
What are seizures and what causes them?
Seizures are a massive discharge of electrical impulses from the brain cells, caused by various conditions such as epilepsy, head injury, hypoglycemia, and more.
What is status epilepticus?
A prolonged seizure lasting more than 20 minutes or successive seizures without regaining consciousness, which is a life-threatening emergency.
What is the Priority Action Approach to a patient with a seizure?
Maintain airway, protect from injury, position laterally, loosen clothing, avoid forcing objects into the mouth, provide oxygen, and suction if needed.
What is the most common cause of spinal fractures and spinal cord injury?
Motor vehicle crashes, even when seat belts are worn.
Why are whiplash injuries common in motor vehicle crashes?
ecause the force of impact can cause muscle and ligament strains of the neck and potentially cervical spinal fractures.
What type of accidents increase the likelihood of spinal fractures, especially if seat belts are not worn?
Crashes involving bicycles, motorcycles, all-terrain vehicles (ATVs), and other mobile equipment.
How does the height and manner of a fall impact spinal injury?
Higher falls and the manner in which the body strikes the ground can determine the type and location of spinal injury, such as fractures of the lower thoracic or upper lumbar vertebrae from landing on the feet.
What should an OFA attendant suspect if a patient falls down a flight of stairs?
The patient is at risk of spinal injury, especially to the cervical spine.
What types of direct blows to the spine can cause spinal fractures?
Assaults, crush injuries, and blunt injuries from falling or swinging objects.
Why is diving into shallow water a common cause of cervical spine fracture?
The impact with the bottom can result in cervical spine fractures, especially in near-drowning victims in shallow water.
What sports are considered high-risk for spinal fractures?
Football, rugby, hockey, and gymnastics.
How can gunshot and penetrating injuries impact the spinal column or spinal cord?
They may directly injure the vertebral column or the spinal cord.
What type of injuries can severe electric shock cause?
Direct spinal cord injury or spinal fractures from violent muscle spasms.
Why should facial and head injuries raise suspicion of cervical spine fracture?
The same mechanism of injury that causes facial or head damage can also cause cervical spine fractures.
What are the different types of spinal injuries?
Spinal cord injury, spinal nerve injury, vertebral fractures and/or dislocations, injuries to the intervertebral discs, strains and/or sprains of the back or spine, or a combination of these.
Can spinal injuries occur independently of spinal cord injuries?
Yes, spinal injuries and spinal cord injuries are different entities and may occur independently.
What risk does moving a patient with a vertebral fracture pose?
It may cause significant displacement of the fracture, resulting in permanent spinal cord or spinal nerve injury.
What percentage of multiple-trauma victims have cervical spine injuries, and what percentage of these have a spinal cord injury?
Approximately 2 to 4% have cervical spine injuries, of which 5 to 15% have a spinal cord injury.
What can cause an incomplete spinal cord injury to worsen?
Swelling, bleeding, or inappropriate handling of the patient.
How do complete and incomplete spinal cord injuries differ?
Complete injuries result in total loss of motor and sensory functions below the injury level, while incomplete injuries result in partial loss.
What is a possible physical finding in male patients with spinal cord injury?
Persistent erection of the penis (priapism).
What commonly causes spinal nerve injuries?
Conditions that cause narrowing of the bony passageways through which spinal nerves pass, such as fractures, arthritis, or intervertebral disc protrusions.
What are common findings in patients with spinal nerve injury?
Pain and partial loss of sensation and motor strength in one extremity.
